Animal bites - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Animal bites that most commonly require medical attention include those inflicted by dogs, cats, or humans.
Description of the circumstances surrounding the bite (i.e., type and behavior of animal) is essential.
Surgical exploration is important, particularly in wounds that are deep or wide or that potentially involve deep anatomical structures.
Cultures may be helpful if signs of infection are present.
Antibiotics are recommended for infected animal bites and, in certain circumstances, noninfected animal bites.

Quick Reference

History & Exam
- Key Factors
- Other Factors
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Diagnostics Tests
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Treatment Options
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Definition

Epidemiology

Etiology

Pathophysiology

Images

Top: breakdown of a leg bite wound and infection 7 days after it was sutured in primary care. Bottom: resultant scarring 18 months later

Citations

Key Articles

Rao AK, Briggs D, Moore SM, et al. Use of a modified preexposure prophylaxis vaccination schedule to prevent human rabies: recommendations of the Advisory Committee on Immunization Practices - United States, 2022. MMWR Morb Mortal Wkly Rep. 2022 May 6;71(18):619-27.[Abstract][Full Text]
Stevens DL, Bisno AL, Chambers HF, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis. 2014 Jul 15;59(2):e10-52.[Abstract][Full Text]
National Institute for Health and Care Excellence. Human and animal bites: antimicrobial prescribing. November 2020 [internet publication].[Full Text]
Centers for Disease Control and Prevention. Advisory Committee on Immunization Practices recommended immunization schedule for children and adolescents ages 18 years or younger, United States, 2024. Nov 2023 [internet publication].[Full Text]
Centers for Disease Control and Prevention. Advisory Committee on Immunization Practices recommended immunization schedule for adults ages 19 years or older, United States, 2024. Nov 2023 [internet publication].[Full Text]

Referenced Articles

1. Jakeman M, Oxley JA, Owczarczak-Garstecka SC, et al. Pet dog bites in children: management and prevention. BMJ Paediatr Open. 2020;4(1):e000726.[Abstract][Full Text]
2. Tulloch JSP, Owczarczak-Garstecka SC, Fleming KM, et al. English hospital episode data analysis (1998-2018) reveal that the rise in dog bite hospital admissions is driven by adult cases. Sci Rep. 2021 Jan 19;11(1):1767.[Abstract][Full Text]
3. Westgarth C, Brooke M, Christley RM. How many people have been bitten by dogs? a cross-sectional survey of prevalence, incidence and factors associated with dog bites in a UK community. J Epidemiol Community Health. 2018 Apr;72(4):331-6.[Abstract][Full Text]
4. Tulloch JSP, Oxley JA, Christley RM, et al. Dog-related deaths registered in England and Wales from 2001 to 2021. Public Health. 2023 Feb;215:91-3.[Abstract][Full Text]
5. Waters A. Rising fatalities, injuries, and NHS costs: dog bites as a public health problem. BMJ. 2023 Apr 27;381:879.
6. World Health Organization. Animal bites. Feb 2018 [internet publication].[Full Text]
7. Loder RT. The demographics of dog bites in the United States. Heliyon. 2019 Mar;5(3):e01360.[Abstract][Full Text]
8. Centers for Disease Control and Prevention. QuickStats: number of deaths resulting from being bitten or struck by a dog,* by sex - National Vital Statistics System, United States, 2011-2021. Sep 2023 [internet publication].[Full Text]
9. Sarenbo S, Svensson PA. Bitten or struck by dog: a rising number of fatalities in Europe, 1995-2016. Forensic Sci Int. 2021 Jan;318:110592.[Abstract][Full Text]
10. Colmers-Gray IN, SP Tulloch JSP, Dostaler G, et al. Management of mammalian bites. BMJ. 2023 Feb 02;380:e071921.
11. Langley R, Haskell MG, Hareza D, et al. Rodent bite injuries presenting to emergency departments in the United States, 2001-2015. J Environ Health. 2021 Mar;83(7):18-24.
12. Freeman AJ, Senn DR, Arendt DM. Seven hundred seventy eight bite marks: analysis by anatomic location, victim and biter demographics, type of crime, and legal disposition. J Forensic Sci. 2005 Nov;50(6):1436-43.[Abstract]
13. Kennedy SA, Stoll LE, Lauder AS. Human and other mammalian bite injuries of the hand: evaluation and management. J Am Acad Orthop Surg. 2015 Jan;23(1):47-57.[Abstract][Full Text]
14. Greene SE, Fritz SA. Infectious complications of bite injuries. Infect Dis Clin North Am. 2021 Mar;35(1):219-36.[Abstract]
15. Talan DA, Citron DM, Abrahamian FM, et al. Bacteriologic analysis of infected dog and cat bites. N Engl J Med. 1999 Jan 14;340(2):85-92.[Abstract][Full Text]
16. Abrahamian FM, Goldstein EJ. Microbiology of animal bite wound infections. Clin Microbiol Rev. 2011 Apr;24(2):231-46.[Abstract][Full Text]
17. Talan DA, Abrahamian FM, Moran GJ, et al. Clinical presentation and bacteriologic analysis of infected human bites in patients presenting to emergency departments. Clin Infect Dis. 2003 Dec 1;37(11):1481-9.[Abstract][Full Text]
18. Manning SE, Rupprecht CE, Fishbein D, et al. Advisory Committee on Immunization Practices Centers for Disease Control and Prevention (CDC). Human rabies prevention - United States, 2008: recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm Rep. 2008 May 23;57(RR-3):1-28.[Abstract][Full Text]
19. Goldstein EJ. Bite wounds and infection. Clin Infect Dis. 1992 Mar;14(3):633-8.[Abstract]
20. Smith PF, Meadowcroft AM, May DB. Treating mammalian bite wounds. J Clin Pharm Ther. 2000 Apr;25(2):85-99.[Abstract]
21. Morgan M. Hospital management of animal and human bites. J Hosp Infect. 2008 May 23;57(RR-3):1-28.[Abstract]
22. Griego RD, Rosen T, Orengo IF, et al. Dog, cat, and human bites: a review. J Am Acad Dermatol. 1995 Dec;33(6):1019-29.[Abstract]
23. Abrahamian FM. Dog bites: bacteriology, management and prevention. Curr Infect Dis Rep. 2000 Oct;2(5):446-53.[Abstract]
24. American Academy of Pediatrics. Bite wounds. In: Kimberlin DW, Barnett ED, Lynfield R, et al (eds). Red Book: 2021 report of the Committee on Infectious Diseases. American Academy of Pediatrics; 2021; 169-75.
25. Plana NM, Kalmar CL, Cheung L, et al. Pediatric dog bite injuries: a 5-Year nationwide study and implications of the COVID-19 pandemic. J Craniofac Surg. 2022 Jul-Aug 01;33(5):1436-40.[Abstract]
26. Lee CJ, Tiourin E, Schuljak S, et al. Surgical treatment of pediatric dog-bite wounds: a 5-year retrospective review. West J Emerg Med. 2021 Oct 27;22(6):1301-10.[Abstract][Full Text]
27. Sacks JJ, Kresnow M, Houston B. Dog bites: how big a problem? Inj Prev. 1996 Mar;2(1):52-4.[Abstract]
28. Rao AK, Briggs D, Moore SM, et al. Use of a modified preexposure prophylaxis vaccination schedule to prevent human rabies: recommendations of the Advisory Committee on Immunization Practices - United States, 2022. MMWR Morb Mortal Wkly Rep. 2022 May 6;71(18):619-27.[Abstract][Full Text]
29. World Health Organization. Weekly epidemiological record. Rabies vaccines: WHO position paper. April 2018 [internet publication].[Full Text]
30. Leone G, Pizzigallo E. Bacterial infections following splenectomy for malignant and nonmalignant hematologic diseases. Mediterr J Hematol Infect Dis. 2015 Oct 13;7(1):e2015057.[Abstract][Full Text]
31. Morgan M, Palmer J. Dog bites. BMJ. 2007 Feb 24;334(7590):413-7.[Full Text]
32. Mensa M, Cubitt JJ, Javed M, et al. Dog bites and diabetic peripheral neuropathy: a dangerous combination. BMJ Case Rep. 2017 Sep 23;2017.[Abstract]
33. Oya J, Hanai K, Miura J, et al. Diabetic gangrene in multiple fingers and toes after a dog bite in an elderly patient with type 2 diabetes. Intern Med. 2011;50(12):1303-7.[Abstract][Full Text]
34. Lee S, Roh KH, Kim CK, et al. A case of necrotizing fasciitis due to streptococcus agalactiae, arcanobacterium haemolyticum, and finegoldia magna in a dog-bitten patient with diabetes. Korean J Lab Med. 2008 Jun;28(3):191-5.[Abstract]
35. American Veterinary Medical Association Task Force on Canine Aggression and Human-Canine Interactions: a community approach to dog bite prevention. J Am Vet Med Assoc. 2001 Jun 1;218(11):1732-49.[Abstract]
36. Shen J, Rouse J, Godbole M, et al. Systematic review: interventions to educate children about dog safety and prevent pediatric dog-bite injuries: a meta-analytic review. J Pediatr Psychol. 2017 Aug 1;42(7):779-91. [Abstract][Full Text]
37. Presutti RJ. Prevention and treatment of dog bites. Am Fam Physician. 2001 Apr 15;63(8):1567-72.[Abstract][Full Text]
38. Centers for Disease Control and Prevention. CDC Yellow Book 2024: health information for international travel. Section 5: travel-associated infections & diseases - rabies. May 2023 [internet publication].[Full Text]
39. Ellis R, Ellis C. Dog and cat bites. Am Fam Physician. 2014 Aug 15;90(4):239-43. [Abstract][Full Text]
40. Evgeniou E, Markeson D, Iyer S, et al. The management of animal bites in the United kingdom. Eplasty. 2013 Jun 10;13:e27.[Abstract][Full Text]
41. Centres for Disease Control and Prevention. Rabies postexposure prophylaxis (PEP): what medical care will I receive if I may have been exposed to rabies? May 2022 [internet publication].[Full Text]
42. Stevens DL, Bisno AL, Chambers HF, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis. 2014 Jul 15;59(2):e10-52.[Abstract][Full Text]
43. Xiaowei Z, Wei L, Xiaowei H, et al. Comparison of primary and delayed wound closure of dog-bite wounds. Vet Comp Orthop Traumatol. 2013;26(3):204-7.[Abstract]
44. Rui-feng C, Li-song H, Ji-bo Z, et al. Emergency treatment on facial laceration of dog bite wounds with immediate primary closure: a prospective randomized trial study. BMC Emerg Med. 2013;13(suppl 1):S2.[Abstract][Full Text]
45. Paschos NK, Makris EA, Gantsos A, et al. Primary closure versus non-closure of dog bite wounds. A randomised controlled trial. Injury. 2014 Jan;45(1):237-40.[Abstract]
46. Chen E, Hornig S, Shepherd SM, et al. Primary closure of mammalian bites. Acad Emerg Med. 2000 Feb;7(2):157-61.[Abstract]
47. Bhaumik S, Kirubakaran R, Chaudhuri S. Primary closure versus delayed or no closure for traumatic wounds due to mammalian bite. Cochrane Database Syst Rev. 2019 Dec 6;12(12):CD011822.[Abstract][Full Text]
48. Callaham M. Prophylactic antibiotics in dog bite wounds: nipping at the heels of progress. Ann Emerg Med. 1994 Mar;23(3):577-9.[Abstract]
49. Cummings P. Antibiotics to prevent infection in patients with dog bite wounds: a meta-analysis of randomized trials. Ann Emerg Med. 1994 Mar;23(3):535-40.[Abstract]
50. Jones N, Khoosal M. Infected dog and cat bites. N Engl J Med. 1999 Jun 10;340(23):1841.[Abstract]
51. Mederios I, Saconato H. Antibiotic prophylaxis for mammalian bites. Cochrane Database Syst Rev. 2001;(2):CD001738.[Abstract]
52. Henton J, Jain A. Cochrane corner: antibiotic prophylaxis for mammalian bites (intervention review). J Hand Surg Eur Vol. 2012 Oct;37(8):804-6.[Abstract]
53. National Institute for Health and Care Excellence. Human and animal bites: antimicrobial prescribing. November 2020 [internet publication].[Full Text]
54. Dendle C, Looke D. Management of mammalian bites. Aust Fam Physician. 2009 Nov;38(11):868-74.[Abstract][Full Text]
55. The British Association for Forensic Odontology. Management of injuries caused by teeth. May 2021 [internet publication].[Full Text]
56. Centers for Disease Control and Prevention. CDC Yellow Book 2024: health information for international travel. Section 5: travel-associated infections & diseases - tetanus. May 2023 [internet publication].[Full Text]
57. Centres for Disease Control and Prevention. Rabies: medical care. June 2018 [internet publication].[Full Text]
58. European Medicines Agency. Quinolone- and fluoroquinolone-containing medicinal products. Mar 2019 [internet publication].[Full Text]
59. Food and Drug Administration. FDA Drug Safety Communication. FDA warns about increased risk of ruptures or tears in the aorta blood vessel with fluoroquinolone antibiotics in certain patients. December 2018 [internet publication].[Full Text]
60. Food and Drug Administration. FDA Drug Safety Communication. FDA reinforces safety information about serious low blood sugar levels and mental health side effects with fluoroquinolone antibiotics; requires label changes. July 2018 [internet publication].[Full Text]
61. Rui-Feng C, Li-Song H, Ji-Bo Z, et al. Negative pressure wound therapy for serious dog bites of extremities: a prospective randomized trial. Am J Emerg Med. 2016 Jun;34(6):1006-10.[Abstract]
62. Iheozor-Ejiofor Z, Newton K, Dumville JC, et al. Negative pressure wound therapy for open traumatic wounds. Cochrane Database Syst Rev. 2018 Jul 3;(7):CD012522.[Abstract][Full Text]
63. Singletary EM, Zideman DA, Bendall JC, et al. 2020 International consensus on first aid science with treatment recommendations. Circulation. 2020 Oct 20;142(16_suppl_1):S284-S334.[Abstract][Full Text]
64. Liang JL, Tiwari T, Moro P, et al. Prevention of pertussis, tetanus, and diphtheria with vaccines in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2018 Apr 27;67(2):1-44. [Abstract][Full Text]
65. Rupprecht CE, Briggs D, Brown CM, et al; Centers for Disease Control and Prevention. Use of a reduced (4-dose) vaccine schedule for postexposure prophylaxis to prevent human rabies: recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm Rep. 2010 Mar 19;59(RR-2):1-9.[Abstract][Full Text]
66. Centers for Disease Control and Prevention. Advisory Committee on Immunization Practices recommended immunization schedule for children and adolescents ages 18 years or younger, United States, 2024. Nov 2023 [internet publication].[Full Text]
67. Centers for Disease Control and Prevention. Advisory Committee on Immunization Practices recommended immunization schedule for adults ages 19 years or older, United States, 2024. Nov 2023 [internet publication].[Full Text]
68. Ji L, Xiaowei Z, Chuanlin W, et al. Investigation of posttraumatic stress disorder in children after animal-induced injury in China. Pediatrics. 2010 Aug;126(2):e320-4.[Abstract]
69. National Institute for Health and Care Excellence. Post-traumatic stress disorder. Dec 2018 [internet publication].[Full Text]
70. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). 2023 [internet publication].[Full Text]
71. Duperrex O, Blackhall K, Burri M, et al. Education of children and adolescents for the prevention of dog bite injuries. Cochrane Database Syst Rev. 2009;(2):CD004726.[Abstract]